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Agts to cntrl BGL

Pharm Test 3

QuestionAnswer
Glucose Regulation
What is the role of the pancreas? To produce insulin, release sodium bicarb, and release pancreas enzymes
What is the role of insulin? It is a hormone produced in the pancreas, when the blood glucose increases too much insulin gets released into the blood
What are other factors that effect it? Adipose hormones, SNS, Corticosteroids, and growth hormone
What is Dibetes Mellitus? It is a sugar disease, alteration in metabolism of carbs, proteins and fats
What is a clinical sign of Diabetes Mellitus? Fasting blood glucose level of >126
What is hyperglycemia? Random blood sugar of >200, pt will be fatigued, lethargic, will be very thirsty
What is Hypoglycemia? Random blood sugar of <40, pt will have a headache, blurred vision, sweating and can lead to coma
What is Type 1 Diabetes? Happens in children; is the destruction of pancreatic cells, caused by virus which makes them not able to produce insulin
What is type 2 diabetes? Occurs in adults and children; usually adults, can be changed with lifestyle modification
What are the types of insulin? Many types
What is the action of insulin? It helos the body store glucose and converts it to glycogen (storage)
What is insulin indicated for? Type 1 and 2 Diabetes
What is it contraindicated with? Nothing unless the pt doesn't need it
What are some adverse reactions of insulin? Ketoacidosis, S&S of Hypoglycemia
What are some drug to drug interactions? MAOIs, beta blockers, aspirin, alchohol
What are the nursing implications for insulin? Assess glucose levels, chack for acidosis, pt will have fruity breath, establish a baseline, diet and exercise teaching
What three insulins are in the rapid acting type? Humalog (Lispro), Novolog (Aspart), and Apidra (Giullsine)
What is the onset of the rapid acting insulins? 15-20 minutes
When should you usually give these to a patient? Give with patients meal
What is the peak of the rapid acting insulins? 30-90 minutes
What is the duration of the rapid acting insulins? 2-5 hrs
What 2 insulins are regular (R) insulins? Humulin R, and Novalin R
What is the onset of the regular insulins? 30 minutes
When would you usually give these to a patient? About 30 min before breakfast
What is the peak of the regular insulins? 2-5 hrs
What is the duration of the regular insulins? 4-8 hrs
What are the 2 types of NPH (intermediate acting) insulins? Humulin N and Novalin N
What is the onset of these? 2-4 hrs
What is the peak of the intermediate NPH insulins? 4-12 hrs
What is the duration of intermedicate NPH insulins? 14-18 hrs (Humulin N) and up to 24hrs (Novalin N)
What are the types of Pre-mixed insulins? Humalog 75/25 (intermediate/shorter acting regular), Humulin 70/30, Novalin 70/30, Humulin 50/50, and Novolulix 30
What is the onset of the pre-mixed insulins? 15-30 min
What is the peak for the pre-mixed insulins? 2-12 hrs
What is the duration of the pre-mixed insulins? 18-26 hrs
What are peakless basal insulins? Once a day insulins, that you DO NOT mix
What are the two types of peakless basal insulins? Lantus (Glargine) and Levemir
What is the onset of these? 1-4 hrs
Is there a peak for these? NO
What is the duration of the peakless basal insulins? Up to 24 hrs
What types of insulins can you mix? Rapid acting, Regular, and NPH intermediate acting
Which two types of insulin can you NOT mix? Pre-mixed and Peakless basal
What two drugs are in the classification: Sulfonylureas? Chlorpropamide and Glyburide
What is the trade name for Chlorpropamide? Diabinese
What is the trade name for Glyburide? Micronase
What is the action of the sulfonyureas? They bind to potassium channels in the pancreas which improves insulin binding receptors in pancreas
What is the indication for sulfonyureas? Type 2 diabetics
What are contraindications of sulfonyureas? No diet and exercise, allergy to drug, if the pt doesn't have a pancreas, or type 1 diabetes
What is the adverse reaction for sulfonyureas? Hypoglycemia S&S
What are the drug to drug interactions of sulfonyureas? Beta blockers and alcohol
What are the nursing implications of the sulfonyureas? Teaching client, baseline, good medical hx, other drugs they are currently on
What is the drug in the classification: Biguanide? Metformin
What is the trade name of Metformin? Glucophage
What is the action of Biguanides? It increases the utilization of insulin; increases the uptake of glucose and absorption of it in the small intestine; does not cause hypoglycemia
What is the indication of Biguanides? Adjunct for type 2 diabetes and used for children less than or equal to 10 years of age
What are Biguanides contraindicated with? Liver and kidney diseases
What are some adverse reactions of Biguanides? Hypoglycemia, lactic acidosis, and N/V
What are the drug to drug interactions? A lot, need to look up
What are the nursing implications for Biguanides? Baseline, chack labs and blood sugar, hold if pt is going into surgery
What is the drug in the classification: Glucose- Elevating agents? Glucagon
What is the action of Glucagon? Brings the blood sugar up and raises the level of glucose
What is the indication of Glucagon? A blood sugar of <40
What are the adverse reactions of Glucagon? N/V
What are the drug to drug interactions with Glucagon? Antioagulants (increases the effect of the anticoagulant)
What are the nursing implications of Glucagon? Get a baseline assessment, check glucose levels, and safety of pt
What are the special considerations for children and diabetes? Need to monitor for S&S of hypoglycemia in type 1 diabetics; Teens may need special care to encourage them to continue diet and exercise
What is the only drug that can be used for children with type 2 diabetes? Metformin (Glucophage)
What are some special considerations for older adults and diabetes? May have complications from diabetes; need to monitor liver and kidney function; need to assess compliance w/ diet and exercise; may need to adjust care to accomodate visual changes and tactile changes; need to monitor feet and skin carefully
Created by: laneygurl6